AOR Template



Sample Agent of Record Change Letter- UnitedHealthcare will accept customer requests to change the Writing Agent and the Agent of Record on a case provided that the request:

- Is made in writing by an authorized representative of the customer on the customer’s letterhead;

- Is directed to UnitedHealthcare (not the new Agent of Record);

- Designates the new Writing Agent and Agent of Record using the names by which they are appointed by us;

- Specifies the lines of coverage impacted; and

- States that the customer’s instructions to name a new Agent of Record supersede other designations, and terminates commissions and other payments to any prior agent.

The language in the following sample Agent of Record change letter meets our requirements and may be used by customers to change the agent assigned to their case.

[Must be on customer letterhead]

[Date]

UnitedHealthcare

Broker Commissions

400 Capital Blvd Fl 2

Rocky Hill, CT 06067

Re: Policy number(s): ______________

Dear UnitedHealthcare,

On __[enter date]__ we have appointed ____[Agent’s name]_______ [(if applicable) at ____[Agency name]___] as our exclusive insurance agent for all lines of coverage [or, if applicable, name specific lines of coverage]. [Adding the Agency’s tax ID number or UnitedHealthcare producer ID after the name is optional, but will expedite processing.] The appointment of ____[Agent or Agency name]____ rescinds and supersedes all previous agent appointments and shall remain in force until cancelled in writing.

I understand that you will make this appointment effective on the first of the month following your receipt of this letter, and that once effective all commissions and other compensation payable from that date on will be paid to the agent appointed in this letter. I represent that I am authorized to appoint an agent for the lines of coverage that are included in this letter.

Sincerely,

[The letter must be signed by an executive or officer who has authority to sign legal documents for the customer Please include the title and phone number of the person signing the letter in case there are questions in this matter.]

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